Using Social Media to Disseminate Effective Pain Treatments for Newborns During Needle-Related Painful Procedures in China.

Social media has become a powerful approach to disseminating evidence to knowledge users. The BSweet2Babies video was developed in multiple languages showing the effectiveness of sweet solutions, skin-to-skin care, and breastfeeding during newborn painful procedures. This study aimed to disseminate the BSweet2Babies video in Chinese through social media platform of WeChat in China; evaluate the reach, acceptability, and recommendation of the video; and assess viewers' previous knowledge and experience of using the 3 strategies and intention to use these strategies in the future. Multiple dissemination strategies were used to maximize views for a 6-month dissemination period. The video received 19 812 views, 4306 "thumbs," and 671 participants completed surveys. Of the survey respondents, 393 were parents. Most respondents did not know these strategies and did not use or help parents use any of them. More healthcare professionals than parents intended to use or advocate for sweet solutions and breastfeeding. More healthcare professionals rated that the 3 strategies were easy to apply in real-life situations, but more parents evaluated that the length of the video was too long. Social media in China can be a promising approach to disseminating evidence on neonatal procedural pain treatments to healthcare professionals and the public.

Barriers and Facilitators to Effective Procedural Pain Treatments for Pediatric Patients in the Chinese Context: A Qualitative Descriptive Study.

PURPOSE: To explore nurse and physician leaders' perceptions of barriers and facilitators to using evidence-based procedural pain treatments (i.e., sweet solutions, breastfeeding, and topical anesthetics) for hospitalized infants and children in the Chinese context. DESIGN AND METHODS: A descriptive qualitative study was conducted at three pediatric inpatient surgical units in one hospital in China. Purposive sampling was used to recruit nurse/physician leaders who were engaged in the clinical management of the 3 units. Data collection included a focus group and individual interviews. The Consolidated Framework for Implementation Research (CFIR) was used to guide the analysis of the data. RESULTS: Ten participants attended the focus group and 13 took part in individual interviews. The findings highlight 41 implementation determinants, including two neutral influencing factors, 22 barriers, and 17 facilitators. These influencing factors aligned with the four CFIR domains and 25 of the 29 CFIR constructs. Common barriers to using evidence-based pain treatments across different contexts were identified, such as health care professionals' limited knowledge and misconceptions on pediatric pain management, no specific policies, low priority, heavy workload, staff shortage, and limited time. Unique determinants in the Chinese context were also identified, including parents' concerns of these new interventions, parent wrath, hierarchical managerial system, and lower authority of nurses. CONCLUSIONS: Multiple barriers as well as facilitators to using evidence-based pain management strategies were identified. PRACTICE IMPLICATIONS: The findings inform further development of implementation strategies and could be used as baseline data for comparing the barriers and facilitators evaluated during and after implementation.

Adverse Outcomes Associated With Intraoperative Anesthesia Handovers: A Systematic Review and Meta-analysis.

PURPOSE: Whether intraoperative handover of anesthesia care increases the risk of adverse outcomes in patients undergoing surgery remains unclear. This systematic review aimed to synthesize the evidence on the association of intraoperative anesthesia handover with delivery of patient care and patient outcomes. DESIGN: This is a systematic review and meta-analysis. METHODS: A comprehensive search was conducted to identify the eligible studies examining the association between intraoperative anesthesia handover and adverse outcomes in patients receiving surgery. The cohort studies and case-control studies were included. The methodological quality of each included study was assessed using the Newcastle-Ottawa Scale. The meta-analysis across the studies was performed using Review Manager. Adjusted odds ratio (aOR) with 95% confidence intervals were used for dichotomous variables. Sensitivity analysis was conducted by removing one study each time and re-estimating the overall effect size. FINDINGS: Seven retrospective cohort studies with 680,155 patients were finally included. Among these participants, 139,362 patients (20.49%) had anesthesia handovers during their surgeries. In pooled analysis, the statistically significant relationship between intraoperative anesthesia handover and composite morbidity was observed (aOR 1.20 and 95% CI 1.12-1.28). However, the number of handovers was not significantly associated with composite of mortality and morbidity (aOR 1.12, 95% CI 1.00-1.25) and in-hospital mortality (aOR 1.26, 95% CI 0.96-1.67). CONCLUSIONS: The findings suggested that each additional intraoperative anesthesia handover increased the odds of composite morbidity. It is important to improve the handover quality and avoid handovers when anesthesia providers have high-risk care events, patients having unstable status, or inadequate handover time.

[Comparative study on substituting hedyseri radix for astragali radix in serum containing yiqiyangxue prescription on aged mice spleen lymphocyte proliferation and anti-oxidant effect].

OBJECTIVE: By substituting Hedyseri Radix for Astragali Radix in Yiqiyangxue prescription, to compare the effects of both serum containing medicine on aged mice spleen lymphocyte proliferation and anti-oxidant effect. METHOD: After using the same dose of Hedyseri Radix to replace Astragali Radix in Yiqiyangxue prescription, the best concentration of serum containing medicine,the best incubation time and the effects of ConA-induced spleen lymphocyte proliferation were determined by MTY method. Use reagent kits to detect the activity of SOD, MDA and ROS levels in aged mice spleen lymphocytes and IL-2 level in culture supernatant fluid of spleen lymphocytes. RESULTS: Both serum containing medicine can enhance the proliferation of aged mice spleen lymphocytes. The best concentration of serum containing medicine was 40% and the incubation time was 72 h. The serum containing Yiqiyangxue of Hedyseri Radix prescription acted more effective than that of Astragali Radix on the enhancement of proliferation. Both serum containing medicine showed similar effects on increasing SOD activity, IL-2 level and decreasing MDA and ROS level. Moreover,serum of Hedyseri Radix was superior in the enhancement of proliferation, IL-2 and the reduction of ROS level. CONCLUSION: Both serum containing medicine of Hedyseri Radix and Astragali Radix generate the same effect of anti-aging and enhancement of proliferation.

Biosynthesis of isonitrile lipopeptides.

Isonitrile lipopeptides discovered from Actinobacteria have attracted wide attention due to their fascinating biosynthetic pathways and relevance to the virulence of many human pathogens including Mycobacterium tuberculosis. Specifically, the identification of the new class of isonitrile-forming enzymes that belong to non-heme iron (II) and α-ketoglutarate dependent dioxygenases has intrigued several research groups to investigate their catalytic mechanism. Here we summarize the recent studies on the biosynthesis of isonitrile lipopeptides from Streptomyces and Mycobacterium. The latest research on the core and tailoring enzymes involved in the pathway as well as the isonitrile metabolic enzymes are discussed in this review.

A robust MRI contrast agent for specific display of the interstitial stream.

Experimental and clinical studies have reported phenomena of long-range fluid flow in interstitial space. However, its behaviours and functions are yet to be addressed. The imaging of the interstitial stream in vivo can clarify its transportation route and allow further understanding of physiological mechanisms and clinical relevance. Here to illustrate the route of the interstitial stream leading to the kidney, we design and synthesize a magnetic resonance imaging (MRI) contrast agent PAA-g-(DTPA-gadolinium). This MRI agent has a high longitudinal relaxivity for higher MRI contrast and large size to avoid leakage across the interstitial space. Using dynamic contrast enhanced MRI, histochemical staining, and trace element analysis of gadolinium, we track the nano-scale PAA-g-(DTPA-gadolinium) transported in the interstitial stream. The agent can be applied for a wide range of imaging and analysis of tissues and organs, thereby enabling advances in the fields of physiology, pathology, and pharmacology.

Building an International Partnership to Develop Advanced Practice Nurses in Anesthesia Settings: Using a Theory-Driven Approach.

The International Federation of Nurse Anesthetists is calling for international collaboration to develop advanced nursing practice in anesthesia settings globally. However, international collaboration is challenging. Limited information is available about what process and factors specifically lead to a successful international collaboration partnership. This article aimed to describe a theoretical and empirical base that can be used to build and maintain long-term international partnerships. The Theoretical Framework of Developing International Partnerships was developed, which comprises seven interrelated concepts including partnerships, collaborations, environment, structure, process for collaborating, outcomes, and sustainability. It was used to guide an equitable horizontal collaboration partnership to develop anesthesia nursing care in local culture and context. Five major challenges were identified during the collaboration process. Sixty-six strategies were developed to facilitate collaboration using the theoretical framework. This work can inform others in establishing an international collaboration and partnership in advancing nursing knowledge and culturally congruent health care delivery.

A theoretical framework for interaction of nursing discipline with genetics and genomics.

BACKGROUND: Since the completion of the Human Genome Project, health science has been strongly influenced by the advances in genetics and genomics. However, the progress of embracing genetics and genomics into nursing discipline is limited. One of the main barriers is lack of understanding on the relevancy of genetics and genomics to nursing discipline. OBJECTIVES: This paper aims to synthesize and develop a theoretical framework for the interaction of nursing discipline with genetics and genomics. METHODS: Through content analysis and constant comparative method, a theoretical framework was developed from synthesis of the studies regarding nursing and genetics/genomics indexed in multiple English and Chinese databases. RESULTS: Four main theoretical statements were constructed in the framework: 1) There are three ways to show how genetics and genomics can influence nursing discipline: a new specialty, new technologies and a new lens; 2) The significant contribution of nursing discipline to genetics and genomics lies in how nurses could focus on the association between human responses and genes and how nurses could advocate for their clients in the genetic and genomic era; 3) A paradigm shift occurs after a constant interaction of nursing discipline with genetics and genomics; 4) Implementation strategies could be used to facilitate the integration of genetics and genomics to nursing discipline and advance the paradigm shift. CONCLUSIONS: The framework will help to understand the relationship between nursing discipline and genetics and genomics and implicate the future studies integrating genetics and genomic science into nursing discipline.

[The family investigation of a weak D type 15 donor].

OBJECTIVE: To study the genetic feature of weak D type 15 allele (RHD845A) in a Chinese family. METHODS: Rh D, C, c, E and e phenotypes of 4 members in a weak D type 15 family were tested by serological and polymerase chain reaction (PCR), D antigen was proven by indirect antiglobulin test. A pair of primers specific for RHD845A were designed, and a sequence specific primer-PCR (PCR-SSP) method was established to detect RHD845A allele in all family members. Subsequently the dual-tube PCR method was used to determine the RHD zygosity of 4 members. RESULTS: The RHD845A allele existed in all 4 family members and the RHD zygosity test showed that all members were RHD +/RHD + homozygous. The parents and nephew possessed one normal RHD gene as RHD845A allele carriers, which caused RhD positive. The proband and his old-sister took two RHD845A alleles, which caused weak D phenotype. CONCLUSION: The proband is the weak D type 15 allele homozygous. The weak D type 15 gene is an ancestral allele, but not a mutation.

Multiple isoforms excluding normal RhD mRNA detected in Rh blood group Del phenotype with RHD 1227A allele.

The RhD mRNA was analyzed in both Rh-positive and D(el) phenotypes with RHD 1227A allele through sequencing. As a result, five and six transcripts were detected in Rh-positive and D(el), respectively. Four of them have identical sequences between Rh-positive and D(el). Those are the transcripts with exon 9, exons 8 and 9, exons 7 and 9, and exons 7-9 spliced out compared normal RhD mRNA that was detected in Rh-positive but not in D(el) individuals. Unexpectedly, two additional transcripts were found in D(el) individuals. Its exon 9 or exons 8-9 were spliced out, but interestingly both possess a 170 bp segment of sequence from intron 7 of RHD. We may conclude that a normal RhD protein does not exist in a D(el) individual with RHD 1227A allele since the exon 9 was always spliced out due to the silent mutation at the end of exon 9. The transcripts without exon 9 was also detected in the normal Rh-positive individual and further confirmed by a specific reverse-transcription PCR (RT-PCR) system.

[Research of RhD protein in Rh blood group Del phenotype].

OBJECTIVE: To study the expression of RhD protein in Rh blood group Del phenotype. METHODS: Peripheral blood samples were collected from 3 voluntary blood donors with different Rh phenotypes: CCD(el)D(el)ee, CcD(el)dee, and CcD(el)D(el)ee, and 4 controls: 2 RhD positive with the phenotypes of CCDDee and CcDDEe, and 2 RhD negative with the phenotypes: Ccddee and ccddee. Reverse transcriptase PCR (RT-PCR) and cDNA sequencing were used to detect the RhD mRNA and the expression of Del protein. RESULTS: The Del individuals all showed complicated RhD mRNA isolations, including 6 transcripts: isoforms with exons 7-9 spliced, exons 7 and 9 spliced, exons 8 and 9 spliced, exon 9 spliced and 2 long transcripts with exons 8 and 9 spliced or exon 9 spliced, but containing an additional segment of sequence from RHD intron 7 (917-1086, GenBank AB035194), those transcripts all being out of exon 9 and the Del9 transcript being the most similar to the normal RhD mRNA. CONCLUSION: Normal RhD mRNA does not exist in the Del blood group that does not code normal RhD protein.

[Generation of RHD-CE(2-9)-D allele by gene conversion in cis].

Previously a few Rh-negative individuals in Caucasian and Chinese were found existing exons 1 and 10 of RHD through genomic DNA testing. The molecular mechanisms, however, remain disputed. In this study, 2 individuals carrying RHD positive, D antigen negative allele (with exon 1 and 10 of RHD) and their mRNA were investigated by using reverse transcriptase PCR (RT-PCR) and sequencing through one pair of specific primers for 5'- and 3'-non-coding region of RHD, taking a Rh-positive (Ccee) sample as control. As a result, the control sample had a normal RHD mRNA, whereas other transcripts were detected in both RHD-positive, D antigen negative individuals, which have same length and exons as the normal RHD or RHCE mRNA. Those transcripts had the same sequences with RHD in exon 1 and exon 10, while the sequences in exons 2-9 were in concordance with RHCE(e) mRNA. It indicated that a hybrid RHD allele, RHD-CE(2-9)-D, was existed in the 2 individuals, in which the exons 2-9 of RHD were substituted by homologous RHCE(e). Thus, this allele could not code normal RhD protein and therefore resulted in Rh-negative phenotype.

Recruitment of voluntary non-remunerated apheresis donors: the second five years' experience in Shenzhen.

The voluntary non-remunerated blood donation campaign in Shenzhen, China, was launched in 1993 and the smooth change from paid donors to unpaid took only a decade. In the first half the volunteer donation system and a sufficient blood supply was promoted and this paved the way for further development in the second half during which the non-remunerated donation system became substantial and integral due to recruitment for plateletapheresis and peripheral stem cells donation as well as whole blood donations. Ninety percent of the donors registered for plateletapheresis do donate and none of the twenty-three non-related donors with matched HLA genotypes broke their promise to donate their peripheral stem cells.

[The family investigation of an RHD 270A allele carrier].

OBJECTIVE: Previously the weak D and D category allele were investigated in Caucasian and Japanese families. The current study is aimed at an RHD positive, D antigen negative allele in a Chinese family. METHODS: A pair of primers specific for RHD 270A allele were designed, and a sequence specific primer-PCR (SSP-PCR) method was then established to detect RHD 270A allele in 6 members of a family. Furthermore, RFLP method was used to determine the RHD zygosity in all family members. RESULTS: The RHD 270A allele was detected in the proband, her father and uncle but not grandmother. Therefore this allele may be from grandfather and is inherited through 3 generations. The RHD zygosity test showed that the father and uncle possess one normal RHD gene as RHD 270A carriers, the mother is RHD(+)/RHD(-)heterozygote and the individual is RHD 270A/RHD(-)which causes an RHD positive, D antigen negative trait. CONCLUSION: The RHD 270A allele is an ancestral allele, but not a spontaneous.

[Whole exon 5 and intron 5 replaced by RHD/CE in partial D phenotype DVa (Hus)].

The study was purposed to analyze DNA and allele structure of the partial D phenotypes D(Va) and D(VI) of the Rhesus blood group in Chinese. Through polymerase chain reaction (PCR) and direct genomic DNA sequencing, the RHD gene was detected in three weak D individuals identified serologically. The results showed that among the three weak D individuals, one was identified as partial D phenotype D(Va) (Hus) type and genotyped DccEe; another two were testified as D(VI) III type and genotyped DCcee. Moreover, the breakpoints of the replaced region by RHCE in D(Va) (Hus) were 5' end of the exon 5 and 3' end of the intron 5, and there were 7 novel polymorphisms in intron 5: 23-25(GCA)2, 98G>A, 168-169insG, 205-206insT, 494-495insA, 1256-1257insC, 1347G>T. In conclusion the whole exon 5 and intron 5 are replaced by RHCE in D(Va) (Hus) detected in Chinese.